[Chair] moved to motion number 77 to be proposed
by Dr Farah Jameel from London Regional
Council for Edgware and Hendon. And may I
ask you to note the erratum that has
been corrected on the screen behind you.
[Dr Farah Jameel] Chair, RB, Healthy
young child goes to doctor, gets pumped
with massive shots of many vaccines,
doesn't feel good and changes, Autism,
many such cases. exclamation mark. This
was a tweet by none other than a certain
President of the United States of
America. Indeed, Mr. Trump's commitment to
being on the wrong side of every issue
is admirable. (laughter and applause from delegates)
But the reality is this: children are
dying of diseases preventable by
vaccination, others are being permanently
harmed. Take Measles, worldwide it's a
major cause of death. In 2015 a hundred
and thirty four thousand two hundred (134,200)
(134,200) people died of measles. Mostly children
in poor communities, an average of 367
every day. What an extraordinary waste of
life. But great progress has been made
through vaccination programmes and in the
last 20 years more than 1 in 5 of all
childhood deaths have been averted due
to measles vaccinations. But the specter
of the Anti-Vaxxer movement is upon us
and wherever it gains a foothold we see
the reversal of these public health
gains. We should condemn the movement
strongly and without reservation and
ensure that policymakers an MP's listen.
Before Wakefield, in this country there
were typically around a hundred (100) cases of
measles a year. In 2012 there were 2016
cases. In the first six months of 2013
there were 1287 cases of measles, 257
of these people were admitted to
hospital including 39 with serious
complications such as pneumonia
meningitis and gastroenteritis. 
Two (2) children in the UK have died of measles
since 2006. What a waste of life. Neither
had been given the MMR vaccine and
during the Welsh measles outbreak in
2013, a young man died of measles
complications. It is said that for good
protection against measles and other
easily preventable diseases it is
recommended that at least 95% of the
population are vaccinated. In 2015-16
93.6% of children reaching their first
birthday had completed their primary
immunization courses against DPT.
Coverage of the first dose of MMR,
for children reaching their
second birth they decreased to 91.9% in
2015-16, and this is a continuing
downward trend in recent years. The stats (statistics)
suggests we've been struggling to reach
the recommended 95 percent for some
years, shying away from the obvious
option of mandating vaccines. Now is the
time to reconsider that position and
follow the lead of such civilized places
as Australia, who have indeed tackle this.
The BMA should be in the vanguard of
this work. If a parent says "I am not
going to vaccinate my child" they are not
simply putting their child at risk, they
are putting everybody else's children at
risk too. This is life and death and we
as health care professionals need to
think carefully about which side of that
discussion we wish to be on. Please
support this motion. (applause) [Chair] Thank you. Now call
Dr. Kiara Vincent from the Junior
Doctors Committee. Dr. Vincent is
speaking against 'little one' (clause 1) and is a
first-time speaker.
[Dr. Kiara Vincent] RB. What percentage of the world's 
one year-olds is vaccinated against measles?
20% 50% 80%? Now ignoring those of you
who've previously taken Hans Rosling's
ignorance test, most of this room
actually won't get the correct answer.
The trend in measles vaccinations in the
world has actually been slowly rising
over the last few years, and the last
data point from 2015, it's the heighest its
ever been at 84.8%. So why the
disconnect? Although vaccination rates
across Europe for the last few years
have slightly fallen, average rates of
course the least developed countries are
on the rise and are often higher than
people expect. Most parents in some of
the least developed countries really do
want to vaccinate their children, they
want to vaccinate them because they've
seen children affected with these
diseases they've seen the effects of the
complications you get, and they have seen
children dying. In the UK and across
Europe we're fortunate that most people
have no experience of these diseases, but
it also makes it easier to trivialize
them.  Easier to convince parents it's
just a rash, easier to feed false
information about the risks of more
common illnesses such as autism, cancer
and therefore some parents choose not to
vaccinate. However we should not condemn
these parents. We don't condemn people
for refusing other treatments,
particularly where we know that they
haven't had access to the correct
information to make that decision. We
need to educate them, support them and
ensure the correct information is
available to parents. These parents
already distrust the medical community,
they're often scared of their children
being harmed by medical intervention and
we shouldn't alienate them further.
I urge you to vote
against 'little one' (clause 1).  Support and
information need to go to parents, but we
should not be condemning them. 
RB, thank you. (applause)
[Chair] Thank you. May I call Iain Kennedy from
Council and Public Health Conference.
He is speaking for the motion.
[Dr Iain Kennedy] Thank you Chair, RB. A quick declaration of
interest, this is part of my day job, 
infact our department last year took over
2,000 enquiries from professionals and
the public on vaccination. I also do
undergraduate teaching on vaccines,
including vaccine law and ethics and in
fact we still use "that" Lancet paper
nearly 20 years old as a case study. Most
of the people in the lecture weren't
born when it was written. So who is an
Anti-Vaxxer? Well, to my mind that word
does not include those parents who are
making a genuine decision based on the
information available to them, even if
that information is stuff we would
consider incorrect. As a father I know
those sorts of decisions can be
incredibly difficult. Me and mine are all
fully vaccinated. To me Anti-Vaxxer
refers to those True Believers who cajole
and intimidate those who do make a
decision to vaccinate, and it means the
leaders of the anti-vaccine movement, who
peddle junk science, patented miracle
cures, and fear. The other group who
should be included in that condemnation
and are missing are those sections of the
media who report scare stories. Now my
understanding, RB, of that word may
well be different from yours and for
others and I can understand the concern
of the previous speaker on that and
why you perhaps might think that would
be better as a reference. I will make a
direct call for 'little two' (clause 2) to be taken as
a reference on a number of grounds: first
the wording, I don't think we should be
presenting such a policy paper to government,
but back to you to make a decision on
what we should be taking forward. This
issue was the understanding of the word
mandatory which varies in different	
jurisdictions from compulsory
vaccination to withholding access to
certain public benefits for those who do
not vaccinate, to in some jurisdictions it
merely means the state's role to pay for it.
And also because AVers are a small
proportion of those a who aren't
vaccinated. 20 to 30 percent of parents
are 'vaccine hesitant',
that means they probably will still
vaccinate a little bit worried about it.
What doesn't work is scaring or 
cajolling them or giving them the
Internet.
What does work is information in a
trusting relationship. Taking 'little two' (clause 2) as
a reference, allows us to go away, do this work, and
bring you back a 'package of measures' to
tackle all the problems with vaccination
rates.  Thank You. [Chair] Thank you Iain. (applause)
 [Chair] May I call Dr. David Smith from Yorkshire Regional Council,
Dr. Smith is talking against the motion
and is a first time speaker. (applause)
[Dr. David Mark Smith] Chair, RB I really dislike this Motion. 
I dislike its language and I dislike what
it says about us as a profession.
To be clear, we absolutely need to increase
vaccination rates, but who are these evil
Anti-Vaxxers? We're not even clear
between ourselves. To me, these are
parents loving parents concerned parents
who feel that they're doing the best for
their children. They are massively
misguided, but they still feel that
they're doing the best. This is a group
of people who are deeply mistrustful of
us. This is a battle for their hearts and
minds, and how we choosing to do this? How
are we choosing to battle for them? We're
going to condemn them. And then worse
still we're going to ask a government,
this government, about whether or not
they think it's right to force treat
their children. This is not the way. This
is not the way. You don't win these
hearts and minds with condemnation, you
win it with compassion. We can bring
these parents back around, we can bring
them back around by rebuilding that
trust, we can do it with a public health
service education policy that leads to
more education for these parents. We can
listen to these parents ideas, concerns
and expectations over and over again so
we win them back around and we will. If
you put this through, if we go to war
with these concerned parents they will
never bring their kids to us again, and
when those kids get ill and sick and we
can do something we will not be given
that opportunity. Please do not pass this,
please a very best vote this through as a
reference. Thank you. (applause)
[Chair] Thank you. I call Dr. Eleanor Draeger
from the ARM Agenda Committee, who's
speaking for (interuption)... if you're quick please
[Chair] Eleanor if you can be prepared to speak
because we were running a bit late, thank you.
[Dr Iain Kennedy] I just wanted to make everyone aware
that the Oxford Living Dictionary
actually has a definition of an
Anti-Vaxxer and says that it is quote 'a
person who is opposed to vaccinations,
typically a parent who does not
wish to vaccinate their child'. Thank you.
[Chair] Thank you, that's a point of information
[Chair] Dr. Draeger
[Dr. Eleanor Draeger] Thank you Chair, RB. I qualified in 2000
and when I was at medical school I was
taught about measles as a historical
disease that I would probably never see.
In 2007 I saw my first case of
measles in a 10 month old baby, who was
really really unwell, wasn't hospitalized
but spent 10 days dehydrated, seeing the
GP every day, with constant fear for
their health. That 10 month old baby was
my son, my first case of me as I saw was
in my own son. He's had every vaccination,
but at 10 months he was too young for
his first MMR. The reason he had measles
is because of the fallout from
Wakefield's paper, something which should
have been historical in my career, is not
historical anymore. My GP had never seen
measles in a child and she retired two
years shortly thereafter. I understand
the points that have been made by the
speakers against, but I think what we
need to understand is that these
illnesses are completely preventable by
vaccination. We need to be strong on this
subject. We need to educate and if
passing a motion like this means that we
are able more to educate, than that is
really important. I also would agree that
'little two' (clause 2) should be taken as a reference,
but I would also like you to 
think about when you're voting on it
the wording of it which says 'to present
a position paper on the advantages and
disadvantages', it doesn't say position
paper on making it mandatory,
it says position paper and looking at
both sides of the question, and then
bring that back so that we can look at
it. Vaccination is a medical miracle and
something that we should be supporting
wholeheartedly. Thank you. (applause) [Chair] Thank you.
[Chair] RB, we have more speakers both for and
against the motion, I would like to know
what you would like to do. Could I see
those who would like to move to the vote
please? Thank you. And those who would
like more debate? We shall move to the
Chair of Committee please. [Professor Dame Parveen Kumar] Thank you, very
much. This is clearly a very contentious
argument, it's been much debated both in
the public arena and indeed in the
papers. To support it would be going
against what the BMA has been saying
through many years in 2009 the Ethics
Committee suggested a voluntary rather
than a compulsory vaccination, we
considered in the Board of Science and
again suggested voluntary, and in 2013
the ARM again decided voluntary.
I think I would support a voluntary
approach in that we could actually ask
the parents by communication and
education to actually get their children vaccinated.
The way the paper is, er, motion has
been worded really sort of condemns that
BMA as actually imposing a compulsory
action on these patients,  so we
would suggest that you reject this
motion.  [Chair] Thank you. I did hear a call the next
business, I would like to hear from the
mover as to why we should not speak to
move to next business please.
[Dr Farah Jameel] Look, this is so contentious, I get it it.
It is difficult, it is uncomfortable, and it
is hard to take one line or the other.
But we as health care professionals, as
leaders, need to have these difficult
discussions, we need to be putting out a
message in the public, in the media, so
the people looking up to us can be
educated about the advantages and the
disadvantages. Now, I think you need to hear
this, I think you need to debate it
perhaps even a bit more, I know we've
decided to move on but I think you need
to take a stand on this and, (to Chair) do you want
me to respond whether I want to take it
as reference as well?
[Chair] Not at this point Dr. Farah. I would like to hear from the
RB, has she persuaded you, would you
like to move to next business? We will
need a 2/3 show of hands if you want to
move to next business, please. Show me
your hands if you want to move to next
business. Thank you. Those who do not want.
Thank you. Chair of Council please.
[Dr Mark Porter] Thank you. The chair of the Board of
Science, Dame Parveen Kumar, has indeed
reminded you that your previous
decisions on this question have
supported a voluntary approach to
vaccination and that is indeed what the
BMA has been out there advocating
because of your previous decisions,
although those decisions do not of
course bind your decision today and you
may choose to change that position. You
need to be aware that that will be
interpreted in the outside worlds as an
absolute change of position, although
part 2 of the motion does indeed refer
to advantages and disadvantages there is
no way that being interpreted in
conjunction with part one it will not be
interpreted as the BMA condemning all
parents who make a choice on whatever
grounds as we're reminded by those who
remind us that words mean what words say
we'll be condemning those who make the
choice not to have their children
vaccinated for whatever reason. And
that's why on ethical grounds and indeed
on scientific grounds, the BMA guided by
you has previously supported that
voluntary approach. We've done previous
analyses by the Board of Science as I
mentioned that
supported that and the last time you
rejected a motion on mandatory childhood
immunization was at the 2013 ARM. Much
has also been made about herd immunity
and the figures and whether we with
international norms and where we are and
so forth. The World Health Organization
target for measles vaccination in order
to induce exactly that immunity is 95
percent. The latest figures in the United
Kingdom from March 2017 indicate that
95.4 percent of
children have received primary MMR
vaccination on the schedules that are
normally published, so to that extent we
already exceed the WHO recommendation
for measles vaccination in this country.
We would of course be able to possibly
to increase that slightly if it were
made mandatory at law, but please
remember what I said at the start, if you
decide, as you can, to change our policy
on this we will be saying to the world
that those parents who make their
informed choice that we've previously
supported must be condemned. [Chair] Thank you.
[Chair] Point of information very quickly please
[Chair] ...can you come to the (podium)....
[Chair] Please keep it to a point of information
[unknown speaker] Thank you very much. Much as I respect Dr. Jameel, she gave
the impression measles rates were going
up, they're not. In 2012 their 2030 cases
in Great Britain and in 2016 only 547.
Thank you. [Chair] Thank you. Dr Jameel please. 
[Chair} I'd like you to say whether you're prepared
to take 'little one' as a reference,
whether you're prepared to take 'little
two' as amended on the board behind me as
a reference and reply to the debate.
please
[Dr Farah Jameel] Okay, so the figures I have and the
figures I've quoted are figures from NHS
Digital and from Public Health England,
so they are accurate. I'll stop at that.
But having having heard the debate,
having weighed up what you should do, I
think the decision lies with you, so I'll
be I'm gonna ask for a steer, what would
you like me to do? Would you like me to
take this as a reference? [RB] Yes... [Dr Farah Jameel] Both parts? [RB] Yes...
[Dr Farah Jameel] Okay, that's what we're going to do. Thank you.
[Chair] RB, we're going to take 77 little
one as a reference, if you support it as
a reference please raise your cards.
Thank you. And those against. We will
have button votes please for accuracy. So
I'm going to wait for the little clock
to appear on the screen and then I'm
going to ask you. Those in favor of
'little one' as a reference,
please vote now. Those in favor. (correcting, button) one
for in favor and (button) two for against.
(For 128, Against 107, 54% For, 46% Against) And that is carried as a reference.
Now we're voting on 'little two' as a
reference, please raise your cards those
in favor. And those against. And that is
carried also. I'm sorry we're out of time
now in that section, before we move to
the chair of Northern Ireland I'd like
to extend my thanks to Professor Dame
Parveen Kumar, to the staff and the members
of the Board of Science and Health, Thank
461
00:20:36,570 --> 00:00:00,000
you. Thank you for all the hard work. (applause)
