For MMR Obsessives, another turn around the circuit

My MMR critic, Michael Ward,  has now posted a  rebuttal of my reply to him. By the way, our old friend Sir Martin Narey has become involved in this  (Some may remember his brief visit to these quarters  - he departed before our discussion on DNA databases and the death penalty was finished.  The final phase of this encounter is to be found here http://hitchensblog.mailonsunday.co.uk/2012/10/martin-narey-retreats-to-his-comfort-zone-and-other-matters.html ). He has joined Ex-Comrade Aaronovitch in endorsing Mr Ward’s work on Twitter, so Mr Ward has now become a proxy for two heavyweight Blairite  figures. Congratulations to Mr Ward, for attracting such powerful establishment support.

 

I reproduce Mr Ward’s latest below, interspersed with my responses in bold type.

 

It is entitled ‘Peter Hitchens, MMR, and the core issue’

 

He begins:

 

‘This began with my previous blog-post in which I "fisked" (to use the current jargon) one of Peter Hitchens's articles on MMR in between waiting for my computer program to compile (nobody pays me for blogging). Mr Hitchens (to his credit I suppose) has now reproduced my fisk in full and added some more words re-defending his original position.

 

Rather disingenuously, Mr Hitchens complains that my "essay (including quotations from [him]) is almost 6,000 words long". Yes Peter, but about 4000 of those words are yours - to which you have now added another 3000. ‘

 

PH remarks: I don’t know what’s disingenuous about this.  Actually, I wasn’t complaining, merely stating a fact and warning readers that there was rather a lot of it, as there is now.  As far as I am concerned, if something is worth arguing about at all, then it is worth arguing about properly. I only mention this because it demonstrates something about my critic’s attitude towards me. He cannot even acknowledge my readiness to give his case in full without adding a grudging ‘I suppose’). We shall observe more of this later.

 

 

 

I could respond to the other statements Peter makes concerning drugs, communism, "shades", guns, GM, Iraq, and electrons, but let's try and stick to the point for once:

 

PH remarks:   Some of the things he lists are in fact central to this argument, which – as I have tried to point out – is essentially a dispute about the individual versus the state, and the freedom of the press. It is a matter of opinion. It is not something about which anyone may be definitively *right* or *wrong*.  You either believe that the NHS belongs to the people, or that the people belong to the NHS. What I object to about his criticism is its self-righteous lecturing tone, its lack of any sort of generosity towards an opponent, and its constant attempt to suggest that I said things I did not say, and did things I did not do.

 

If, in spite of all the considerations I've outlined, Peter Hitchens thinks that the NHS should have offered single vaccines at the height of the scare, he is (as they say) "entitled to his opinions."

 

PH remarks: That is jolly kind of him. As for the ‘in spite of’, none of the considerations he has set forth has any bearing on the following simple point, which he has never addressed properly nor attempted to rebut. It is highly likely that, had the single vaccines still been available on the NHS, a large number of the children who were not given the MMR would have been given the single jab, and the present outbreak of measles would not have happened. I state this in the most modest possible terms. 

 

 

 

The experts feel, on balance, that this would have done more harm than good overall. Peter Hitchens feels the opposite.

 

PH remarks. His ‘experts’ believe this, but they are not neutral observers. They supported the ‘MMR or Nothing’ policy and it is hardly in their interests to admit that it was a failure. I am on record as saying *at the time* that it would fail and why. At the time, they assumed it would work.  I rather think my warning has been borne out and their assumption has been shown to be wrong.   I do not ‘feel’ anything. I believe that all the evidence suggests that it would have been so. The objections to continuing with the single vaccine can be met as follows. 1. Fears about the quality of unregulated single vaccines could easily have been overcome by the NHS continuing to supply it, and maintaining quality control. 2. The claim that parents would not have completed the programme of vaccinations are just that, claims. In my experience, the worried parents were overwhelmingly among the more responsible and thoughtful parts of the population. It was precisely because they were conscientious and thoughtful that they were worried about the MMR. Why should it then be assumed that they would fecklessly fail to ensure immunisation? This is just lofty contempt for the masses , from the very people who claim to love them so.  3. We know beyond doubt (because it happened) that the government’s chosen course, of offering the MMR or nothing, led many parents to say ‘very well, then, nothing’. As an attempt to enforce take up of the MMR, this policy was one of the most abject failures of public health policy in recent years. In a free society, compulsion through refusal of choice doesn’t work.  People just choose to do nothing, rather than to do what the state wants. Who is responsible for the failure of government decisions? Why, the government that takes them. Certainly not the free people who refuse to be bossed about in this manner.

 

Mr Ward says  In the end, nobody can say for certain what the two outcomes would have been of the two competing policy decisions. It's a matter of judgement. I incline (steeply) to the expert judgement and I find the reasoning behind Peter's view wanting, but I accept that Peter has every right to express a different view here.

 

PH comments: Once again, it is jolly nice of him to concede to me the freedom to have a different opinion on the nature of government, its powers and responsibilities, and on the freedom of the people, from his almighty selfness. But I have to tell him that I couldn’t care less. I had that freedom already. My forebears won it for me, and protected it from danger, as I now seek to do for my children.

 

If he finds my reasoning ‘wanting’ then he has yet to explain how or why. His inclinations are obviously obedient, conformist and statist, and he is the perfect citizen for our modern world (as I am not).  But if he wants to criticise my reasoning,  he has to show some sign of doing any of his own. He still hasn’t explained why he continues to claim that a policy which has demonstrably failed – the policy of MMR or nothing - was better than the alternative. Let me repeat. The policy which he favours was an abject failure. It did not work. It flopped. It did not achieve its intention.   

Let me repeat the simple point. The ‘MMR or nothing’ policy failed. Thousands of grown-up people refused to be bullied into allowing their children to have the MMR. That is why we have the problem we have now.  That failure lies on the shoulders of those who decided to adopt it, who plainly knew nothing of human nature or of parental love, and who have yet to learn their lesson. 

 

Mr Ward continues: ‘But this is not all Peter said.

 

‘If, in spite of all the science to the contrary, Peter Hitchens thinks that MMR may cause autism,…’

 

 

PH comments. This is very slippery. He knows perfectly well that I  repeatedly said in my 2001 article that I did not know or pretend to know the answer to this question. But he needs (as we shall shortly see) to try to portray me as some sort of anti-scientific scaremonger,  hence this disreputable conditional sentence, willing to wound but fearing to strike.

 

 

Mr Ward continues ‘…he is not entitled to that opinion in the way he is entitled to his opinion about single jabs.’

 

PH comments : Thus the underhand, half-made accusation is advanced on the edge of a remark, just enough to damage, not enough to get him into blatant trouble with the truth. I love the way that those who like to pose as above-the-fray ’scientists’ will resort to such tactics when in trouble. I haven’t expressed any such opinion.

 

Mr Ward continues ‘But let me explain what I am saying and not saying here. (I shall come in a moment to what Mr Hitchens actually says.)

•Though I rather wish Mr Hitchens had not expressed his opinions, I am not saying he should be prevented from expressing his opinions.

•I am not saying that science is always right. Science is based on the current best evidence and is constantly revised in in response to the latest evidence. Occasionally there are mavericks in science who challenge the status quo, are ridiculed, and then turn out to be right. Most of the time, however, mavericks turn out to be wrong.’

 

PH comments. Well, this is fantastic news. And if these so-called ‘mavericks in science’  turn out to be right, then where would we have been if we had ignored or decried them, especially if their warnings had in fact turned out to have saved lives or saved people from danger, and we could have saved more people from death or tragedy had we listened to them sooner? And who coudl know in advance that this would or would not be so?

 

As long as such things happen, the layman in the media is not entitled to make a judgement on whether to publish their warnings. Nor, given the record of governments and drug companies, can the layman in the media, or the ordinary subject,  assume that the majority is right, or that the government is right.

 

And once you have memntioned the controversy the public will take its own view. This was the point of the quotation from Sarah Boseley of the ‘Guardian’, no friend of mine or of my opinion, which I included in my riposte. The ‘responsible’ (often meaning conformist,  cautious, statist, conventionally wise) course may well turn out to be a deeply damaging one. Governments are often wrong. Weapons of mass destruction; the heterosexual AIDS epidemic; the beef scare; the bungled foot-and-mouth outbreak; the disgusting neglect of patients in some hospitals. The list is long.  That is what I meant by freedom necessarily being irresponsible. The media must be *free* to criticise. That means it, too, must be free to make mistakes. Because without that freedom it cannot expose the more important mistakes of governments.

 

 

Mr Ward continues; ‘•There is nothing wrong with journalists reporting the views of maverick scientists or even their own maverick views providing such views are placed firmly in the context of whatever mainstream scientific opinion is at the time. This is particularly important when the general public (who do not read scientific literature) may react to a report in the media and put their own health or (especially) that of their children at risk. ‘

 

PH responds. I couldn’t agree more. And in that 2001 article, that is exactly what I did. My only objection here is to the use of the word 'maverick' as a known factor. How can we know? And, as I have pointed out rather a lot, my 2001 article was written when the controversy was already well-established in the public mind.  He flatters me graetly if he imagines that a 2,500-word long read towards the back of the book of a Sunday newspaper will have had much effect one way or the other on mass public perceptiosn of the MMR. If Mr Ward wishes to criticise any other journalists for what they write, let him do so with specific examples. My own impression is that the problems were in general legitimately reported by the media, some taking one view, some the other, as is only proper in a plural society, and also that the problems which followed, of reluctance to allow children to be given the MMR,  could easily have been avoided by following the policy I advocated at the time, of continuing to make single vaccines available to those who were concerned.

 

 

Mr Ward continues ‘Now Mr Hitchens claims that he is not saying that MMR causes autism: …

 

PH retorts : ‘I do not *claim* any such thing, I *say* so. The use of the word ‘claim’ implies incredulity on the part of the person who uses it, and hints to the reader that the statement is not to be trusted. On what, precisely,  does he base this incredulity? What entitles him to urge this mistrust on his readers? Once more, he is resorting to the slippery and the underhand, never a good sign.

 

Mr Ward quotes me

‘…were I arguing that Dr Wakefield was right, or the MMR was dangerous, I would need to show my qualifications before doing so. [...] But I am not.’

 

PH remarks . I should have thought the words ‘I am not’ were pretty clear. A simple unambiguous statement in words of one syllable. But watch what Mr Ward now does with this material.

 

 

‘The problem is that this statement - though strictly true - is again disingenuous. Let's take just one of Mr Hitchens's sentences:

“The claims of an MMR risk have not been proved, but nor have they been disproved.”

This sentence is of course true. The problem is that it is always true no matter what empirical claims you put in there. For example, try substituting "for the existence of unicorns" for "of an MMR risk". The sentence is still true.

 

PH comments. I am used to this nursery stuff in debates with atheists. It’ll be orbiting teapots, flying spaghetti monsters and Father Christmas next.  There is no evidence for any of these things, nor do they explain anything which is unexplained.  There *was* evidence suggesting that there *might* be reason to worry about the MMR.   At the time that I wrote the article involved, 2001, the issue was still one of controversy.  Mr Ward disagrees with this because of his inclination to be on the side of authority. That does not make him right or me wrong.  Nor does my inclination to refuse to believe anything until it has been officially denied (Bismarck’s advice) make me right and him wrong. A free society allows us both to exist simultaneously, and causes necessary imperfections in the order of things.

 

A group of qualified doctors had raised a difficulty with the MMR in 1998. The process which has since led to the discrediting of their claims had hardly begun by 2001, and was certainly not over. The original MMR had in fact run into problems in 1992 (not over autism but over its mumps component), difficulties which must have raised general questions about it in many minds. 

 

Two of the original vaccines had been withdrawn.  It is also the case (recognised by any serious person) that almost any vaccine can carry a risk for a minority. Many people have always feared vaccines for this reason. Fears which might normally have been dormant, or been reduced to a belief that the risks were so small that they were most unlikely to arise, were instead very widespread. What Mr Ward seems entirely unable to understand is the presence of fear in the human mind, especially fear in  parent’s mind for the safety of a child.  You can’t lecture or shout it out of existence. Sometimes you just have to recognise its existence, and treat it sympathetically.

 

 

Mr Ward ( and I don’t recall us being formally introduced, so I wish he wouldn’t refer to me as ‘Peter’) continues : ‘Sentences like Peter's, which are always true no matter what is the case, do not tell us anything about the world; so Peter is correct. He has not made a false factual claim here

 

‘Nevertheless, this sentence, without actually saying anything, puts the false idea into a reader's mind that there is some credible doubt about the safety of MMR.’

 

PH comments. Ah, so I haven’t actually said anything untrue. But someone might get a false impression from what I have said. So I have sinned. Well, what is this sin? That  ‘this sentence, without actually saying anything, puts the false idea into a reader's mind that there is some credible doubt about the safety of MMR.’

I will go further than Mr Ward’s coy formulation. The sentence states clearly that there is a possibility that there might be such a doubt. On the other hand, I will say that there was, when I expressed it,  nothing *false* about it this idea.  When I wrote the 2001 article, I thought this was so. Mr Ward’s certainty that the controversy was over and done with by 2001 is, frankly, absurd. How old was he at the time?  And I was, in my view, entitled to think that this was so.  I was mistaken, but I did not *know* that then, and nor did Mr Ward *know* it, though it may have been his opinion, a different thing (though he tends to confuse the two, as so many of my opponents do).

 

I do still worry that the possibility exists that a small minority of children may react badly to this (and other) injections, and that the authorities may regard this as an acceptable price to pay for mass immunisation, an interesting moral problem we could discuss elsewhere, but one which (inevitably) looks different if you suspect that your child is one of the small minority. That’s why I quoted Vivienne Parry’s interesting remarks on this subject in my original article. Does he disagree with her, by the way?

 

Had Mr Ward written at the time that the matter was satisfactorily resolved, he would have been expressing a certainty to which he was not entitled. His instincts,  as we have discussed, are to side with establishments, authorities, mainstreams etc. Mine are to do the opposite. It is perhaps a good thing that I am journalist, and he is whatever he is. There was open disagreement among those qualified to judge. I wasn’t qualified to decide between them.  I had,  as it happened, played precisely zero role in creating those doubts. They existed quite independently of me, and had grown up as the result of the writings and sayings of qualified doctors and of experienced medical writers. That was why, before I ever put finger to keyboard, thousands of parents had decided that they were not going to give their children the MMR. It had happened.

 

Mr Ward continues ’As I write, there are hundreds of children across the UK suffering from measles. Dozens have been hospitalized. I have a great deal of "human sympathy" for these children and their parents’

 

PH replies : In that case, why can he not see that bullying those parents with the ‘MMR or Nothing’ alternative patently did not work, and did not work because it was never going to work, and was a mistake, and is the reason for the hundreds of children suffering from measles, about whom he now says he is so concerned. It is more than likely, in fact practically certain,  that these children are the children of parents who were offered the ‘MMR or Nothing’ option and predictably chose ‘nothing’ .

 

 

Mr Ward says ‘ - which is precisely why I became angry enough to write my original attack on Peter Hitchens's article.’

 

PH responds :I am not sure about the ‘precision’ here. And I would say that anger and reason seldom go hand in hand.  He hasn’t shown that my article played any part in this. It was written when the controversy was already old and well-established,  when doubts about the MMR were widespread, and after the authorities had adopted the ‘MMR or nothing’ policy and indeed after that policy (high-handed and insensitive as it was)  had begun, inevitably, to fail. By that time doctors were being paid large bonuses to increase MMR uptake, and much of the media, plus the government, were shouting repeatedly at parents that the MMR was safe. I was one of those parents. I remember it well. They’d been doing so for ages. It wasn’t working. My article advocated a return to the policy of offering single jabs on the NHS. Had this policy been adopted, most of those now suffering from measles wouldn’t be.

 

Mr Ward contends :’This would not have happened if those children had been given the MMR vaccine at the recommended time.’

 

PH replies : ’We are now in the good old territory of ‘If we had some ham , we could have some ham and eggs, if we had some eggs’. Can he not grasp that the parents involved were not, under any circumstances short of force, going to give their children the MMR? All manner of persuasion had been tried, their minds were made up, much as his mind is made up about my personal wickedness, bless him.  I strongly suspect that the bullying attitude of the government, far from increasing coverage, served to persuade many waverers to refuse the MMR. When it turned out that the Blairs were not prepared to say what their own personal policy was, that put the lid on it.  Why, then , is he so anxious to blame me (who never wrote a word on the subject from 1998 to 2001), rather than the government?

 

Mr Ward says :’The reason they were not given the vaccine at the recommended time is that their parents were scared.’

 

PH. This is absolutely true.

 

Mr Ward says : ‘The parents were not scared by (no longer a Dr) Wakefield's original paper - which they never read and which was thoroughly discredited by other experts within months of its appearance and utterly discredited by 2001. The parents were scared by what they read in the newspapers.’

 

PH replies : These are assumptions we cannot test. My guess, from many discussions with people about where they get their ideas from, are a bit different. Some parents may indeed have read the Wakefield papers. Some may have been influenced by newspapers. Most, I suspect, became aware of a concern as part of the background noise of their lives, almost certainly from TV and radio, already by 1998 much the most powerful media,  far more than from newspapers.  They had it in their minds that there was a dispute about the matter. They had (as most parents have) a worry about allowing needles to be stuck into their children. They didn’t think measles was that serious a problem, having had it themselves and not suffered greatly.  They resented the bullying attitude of the authorities and were made suspicious by it.

 

Mr Ward says :’Even if it were true that things would have been better if the NHS had supplied single vaccines (it almost certainly isn't true but let's let that pass)’

 

PH: No,  I will not let it pass. Why would it ‘almost certainly’ not have been better? On what basis, other than his own fervently pro-authority view, does he reach this bizarre conclusion? The parents feared the MMR, not single injections, which had been available since 1968 and had never been controversial. Even if the masses were the feckless, irresponsible people he assumes them to be (and they are not) it is surely beyond all doubt that more children would have been immunised against measles had the single jab been readily available at their GP surgery  after the Wakefield controversy began. He really must explain why a choice of MMR or single jab would have had *worse* results than the ‘MMR or nothing’ policy, which has had the results we now see. Nobody suggested the withdrawal of the MMR, just its continued availability alongside an alternative for those who were worried.  Of course, I know he won’t. He’s much too anxious to blame free speech and a free press, to take the responsibility away from his beloved state.

 

Mr Ward says ;’It would still be the case, I submit, that the actions of journalists (including Peter Hitchens) were deeply irresponsible and were partly responsible for the current epidemic.’

 

PH replies . He can say this if he likes. I don’t much care. I’ve been, as I so often have cause to say, insulted by experts.  If he regards my actions, which were aimed at the sensible resolution of a difficult problem (and which I firmly believe, had they been heeded, would have avoided that problem)  as ‘irresponsible’ then that’s just a difference of opinion over what amounts to ‘irresponsibility’ . I don’t impugn his motives. I think he’s an honest authoritarian utopian, of a kind who can do much good provided he’s balanced in society by people who aren’t quite so willing to take the state at its word.

 

Lots of factors contributed to the current outbreak (is it an epidemic? I wouldn’t have thought it had reached that stage but I’m not sure of the technical definition) . I would list them as : Honest doubts expressed by doctors ; legitimate coverage of those doubts across all the media; worry among parents, often highly emotional; highhanded bullying by the authorities and foolish secretiveness on the part of Downing Street, the refusal by the authorities to understand or sympathise with the fears of parents, and to give them an alternative they would accept. Lots of children not immunised at all.

 

Mr Ward concludes: ‘Nothing Peter has to say about drugs, communism, "shades", guns, GM, Iraq, or electrons changes this uncomfortable conclusion.’

 

PH. Nor am I sure why they would. Stick to the subject. Comrade Aaronovitch will understand the stuff about Communism. It’s him it’s aimed at, and he knows (unlike Mr Ward, who plainly knows little about me) why I’m bothered about it.

 

It’s my suspicion that nothing of any kind would change Mr Ward’s mind (in this he is quite like the parents who wouldn’t let their children have the MMR in 2001, though he will never see the similarity). A made-up mind is a made-up mind, and the difference between us is, as I say, principally one of temperament.  I suspect that he likes humanity as an idea, but finds individual humans a bit awkward, especially if they disagree with him. He trusts authority. I don’t. I think the NHS belongs to the people. He thinks the people belong to the NHS. There’s no resolution to these differences, which will always (I hope) exist in our country.  That’s why we have an adversarial parliament. But it helps if both sides respect the motives of the other, and assume a common humanity. It’s the censorious lack of generosity in his tone that I find disquieting.