Controversial drama Hear The Silence looks certain to be good TV. But will it be a reliable source of information about autism and MMR? STEPHEN LEWIS reports.

WHEN it comes to ratings, Channel 5 looks certain to be on to a winner. Every parent in the country tearing themselves up over whether to allow their child to be given the measles, mumps and rubella (MMR) vaccine will be glued to their TV set on Monday night for the powerful new drama Hear The Silence.

The two-hour film stars Juliet Stevenson as Christine Shields, a mum desperate to find out what caused her young son Nicky's severe autism. The storyline is apparently based on the experience of real-life mum Kathleen Yazbak, whose son Theo, now ten, developed autism not long after being given the MMR jab six years ago.

In a parallel storyline, the drama also focuses on the work of Dr Andrew Wakefield (to be played by actor Hugh Bonneville) - the London doctor who first suggested there could be a link between the MMR vaccine and autism.

No one who has seen any of the previews, in which an anguished Stevenson berates an indifferent-looking GP, screaming at her to "look at my son", will be in any doubt that this is going to be an emotional and involving piece of drama. And many parents of autistic youngsters who have experienced the anguish of watching their own children withdraw into a strange world of their own will doubtless identify with the screen mother's pain and anger.

Just because a programme makes good drama and taps into a national sense of disquiet and unease about MMR doesn't mean it will necessarily provide reliable information, however.

So will Hear The Silence really be an objective and unbiased look at the evidence for the so-called 'link' between MMR and autism?

Experts fear not - and claim that by tugging at the emotional heart-strings, it will only increase the levels of confusion surrounding the issue.

Public fears about the jab mean the national take-up of MMR in young children has already plunged to about 79 per cent - well below the figure needed to provide what experts call 'herd' immunity. That means the risk of an outbreak of measles or mumps is becoming a real possibility - and some believe the drama could make things even worse.

Stevenson herself insists Hear The Silence is not meant to be alarmist, but that it is a "story that needs to be told".

"I hope it won't alarm people, rather I hope it informs people," says the actress who, as a parent herself, admits she has not allowed her youngest child Gabriel, aged three, to have the jab.

"There is a need for a calm and open conversation about all this so that people can find out whether their children are at risk or not. No one has ever said MMR is dangerous, they're just saying that for a small but significant number of children it may possibly be damaging."

Professor Alan Maynard, chair of York Hospitals Trust, says he has real concerns about the programme, however.

The danger of emotionally dramatising such a sensitive issue, he says, is that it could frighten parents and put even more of them off having their children vaccinated.

He says the evidence is overwhelming that the risks associated with having the MMR jab are very low - even Dr Simon Burch, a former collaborator of Dr Wakefield, has now come out openly and accepted that. The potential risks to children of not having the jab, however, could be very high - with a real risk of serious outbreaks of measles or mumps if levels of immunity continue to fall.

It is essential the programme presents a balanced picture, Prof Maynard says. "If they (the programme-makers) cannot get a good balance then it is obviously going to cause great concern among parents and young mothers. I do worry that there is going to be an outbreak of this disease (measles) and that it could do real damage."

To be fair, Channel 5 is planning to screen a one-hour debate after the programme, chaired by Kirsty Young, in which experts from both sides will discuss the issues raised.

But will that in itself be enough to counter the damage if the drama is one-sided? After all, which are people most likely to be influenced by - an anguished Juliet Stevenson raging against an uncaring NHS bureaucracy while she sees her screen 'son' slip further away from her into a mysterious world of his own? Or a panel of experts bandying dry statistics about and failing to agree with each other? In such a debate, where equal weight tends to be given to each side of the argument, it often matters very little that the overwhelming weight of professional opinion is ranged on one side rather than the other.

Prof Maynard says that if Channel 5 is serious about wanting to genuinely inform viewers, it should stage the debate before the drama at 9pm, rather than afterwards at 11.05pm. If it is held afterwards, many viewers will probably watch the drama, then switch off and go to bed without listening to the experts at all, he says. "I should much prefer they have a programme before the drama, which presents the evidence very clearly then says OK, what follows is a nice little drama but here are the real facts," he says.

That, of course, won't happen. Nor should it necessarily, says Chris Wood, TV consultant and boss of York-based independent video production company W3KTS.

He is all in favour of dramas such as Hear The Silence, which try to responsibly tackle issues of importance. As a parent himself, he says he understands the dilemma other parents find themselves in over MMR. His own two youngest children had the jab last year, and have suffered no ill effects. "But it is certainly a common problem thatmany parents will have to go through, whether to do it or not," he says.

The Prime Minister, Tony Blair, hardly set a good example when he refused to divulge whether his young son Leo had had the jab, says Chris. "That is why it is good to bring it out into the open, so people can talk about it."

What the drama must do, however, is flag up the fact that it is only that - a drama. It must make clear that it is an 'authored piece', rather than something factual. And it is vital that the subsequent debate be full and balanced, he agrees. "If it is not, then Channel 5 is not being responsible."

Above all, he stresses, it is vital that everyone with a concern about the issue watches the debate afterwards rather than simply relying on the drama for their information.

"People cannot say 'I saw the drama and I know all about it now,'" he says. "If they do that, they are still going to be talking from a position of ignorance."

Hear The Silence is on Channel 5 at 9pm next Monday. The MMR debate, chaired by Kirsty Young, follows on the same channel at 11.05pm

Updated: 11:07 Thursday, December 11, 2003