Health and Social Care Update

Baroness Thornton Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for the Statement from last Thursday. We heartily welcome the rollout of the vaccine and place on record huge gratitude to the scientists from everywhere, the NHS staff—all of them—the local government officials, the pharmacists and the volunteers who have worked so hard and seamlessly to produce such a successful outcome so far. I also take this opportunity to support the AstraZeneca vaccine. I am sure we were all very pleased with the news from the USA, which supports all the scientists in the UK and Europe, that the AZ vaccine is both effective and safe.

However, it was not great news to learn that this amazing vaccine effort will have to slow down due to supply problems, and, I have to say, that did come as a surprise. We have one of the worst death rates in the world and our economy has taken a massive hit. Many key workers under the age of 50—such as teachers and police officers—who through the nature of their work have not been at home, are going out and are more exposed to risk. I imagine that many had hoped that vaccination for them was not very far away. An update on the vaccine supply, particularly on the issues around discussions with the European Union, which seem to have become more fractious, would be appreciated.

But, specifically, what has happened to the Moderna vaccine? I understand that it will start in April. Is there any prospect that, if Moderna supplies come on stream, new appointments can be offered in light of that? Can the Minister assure the House about the second vaccine which many of us await? Will there be sufficient supply and will providing the millions of second jabs delay further the first vaccines for the 30 and 40 year-olds? It seems that the vaccination programme will need to ramp up to about 3.5 million doses a week from May to ensure that everyone under 50 is vaccinated by mid-July. Is the Minister confident that these supply issues will be fixed by May?

Adam Finn of the Joint Committee on Vaccination and Immunisation said that infection rates may rise as a result of the delays. Does the Minister anticipate that any of the stages or dates in the road map for easing out of lockdown will be pushed back, given that we are rightly judging the road map by data, not dates?

There are two other issues that we particularly need to address today. May I ask about the impact of the EU-AZ concern on vaccine hesitancy in the UK? It has been reported that there was a jump in no-shows and people questioning or refusing to go ahead with the AZ vaccine in the last week or so here in the UK.

Many poorer areas today still have the highest infection rates relative to elsewhere in the country, and at the same time their vaccination rates are below average. The worry is that places such as Oldham, Leicester or Hartlepool might be facing a double whammy: they still have high infection rates, but they are not getting the vaccination rates up to the levels needed. Not only will the disease continue to circulate there, with the risk of people catching it becoming severely ill, this also raises the question: will these towns and cities be left behind as the rest of the country eases out of lockdown? Some areas such as Leicester have endured the longest coronavirus restrictions of any part of England, remaining in lockdown since last summer. Closer to home here in London, I understand that in Enfield there are 16,000 people who do not have GPs and are in wards with high levels of poverty, high Covid rates and low vaccine rates—some as low as 55%. What are the Government’s plans to support these areas and ensure that they are not left behind?

Secondly, vaccination centres are detecting a rising number of queue jumpers as Britain prepares to face a four-week jab drought. Officials say that people pose as care or health workers to cheat their way to an early jab and fear that fraudulent bookings will soar before next month’s slower rollout. When the cheats are caught, vaccination slots that could have gone to people entitled to a jab are wasted. In addition, according to anecdotal evidence and the Times article of yesterday, it seems that some centres more recently are not being diligent about requiring proof of the eligibility of the person claiming to be a care worker.

Anyone can fraudulently book a jab on the national booking website by ticking a box to say that they work in health or social care or provide “personal care” for people in their homes. The NHS insists that those who do this but do not bring proof of that to their appointment “will not be vaccinated”. But officials say that the loophole means that rising numbers are trying to exploit a system that is “open to abuse”. Some sites are catching 15 queue jumpers a day and fear that more are slipping through. The problem is that those appointments are lost and those vaccinations wasted. The centres therefore face a “difficult balance” between wanting to avoid wasted doses and appointment slots and rigorously checking ID cards. Bhaveen Patel, who runs a Covid-19 vaccination clinic in Brixton, says that he turns away 15 queue jumpers a day.

Finally, children make up about 21% of the population. That is a large segment of the population who will lack immunity. Obviously, research and trials are ongoing, but does the Minister have a timeline for when he hopes to vaccinate children? Does he anticipate, for example, being able to vaccinate children this autumn, as Anthony Fauci in the US has suggested could well happen over there?

[Baroness Brinton (LD) [V]]

My Lords, from these Benches I also thank the noble Lord for the Statement given in the Commons last Thursday and thank and congratulate everyone involved in the creation and delivery of all the vaccines so far, and for their continuing work to protect the world against mutant strains of the virus. It is good news at a time when much else is still worrying.

I also start with the availability of supply. Can the Minister explain to the House what guarantee there is for people on receiving their second doses? He has reassured the House before, but I am hearing from GPs worried that they have not had confirmation that they will receive enough doses or that they are getting any supplies at all at the moment, as well as from people who have had their first dose from their GP but who have been told they cannot book their second dose via the online national system because their first dose was delivered by their GP. There are a lot of confused people around.

Today’s news about the EU-UK war of words on the vaccine supply chain gets more bizarre by the hour. Are Ministers seriously considering holding back exports of the special lipids from the UK to the EU as a proposed retaliatory action if the EU holds back doses in the Netherlands? There should not be a war of words but the best possible collaboration to ensure that the “lumpy supply”, to quote the Prime Minister, is smoothed out.

On the issue of queue jumpers, both the NHS and the care sector have an effective ID system that has been in place for some time, although obviously it was probably easier to do when they were in the first group of people to be vaccinated. What are the Government doing to ensure that every vaccine centre understands what they need to see from people presenting for vaccines from the care sector?

On the hesitancy in uptake, I too have heard of the increase in no-shows. What are the Government doing to encourage especially those from the first six groups who have not yet come forward to do so? The publicity campaign that is beginning on reassurance about the AstraZeneca dose is good, as is the test news, but we need much more than that. We know that hesitancy tends to be reduced when people, especially doctors and nurses, talk directly to their patients.

As we have said from these Benches, it is good that the UK is playing its part in funding vaccines via COVAX. However, there is a lot of discussion at the moment that the UK should support TRIPS and encourage the sharing of intellectual property rights of vaccines. I have some concerns about this approach and agree with Professor Sarah Gilbert, who said:

“If another company tries to take the IP and go it alone, they are manufacturing a different product. The regulators would see it as a different product; it would have to go through all the efficacy trials again, and that would be very wasteful and very slow. I want to get rid of the idea that we should be sharing the IP and letting everybody make their own vaccines. It does not work like that. We have a way of sharing the materials and the expertise, and that is what we have been working very hard to do. That is the correct way to do it, because that is how we get the right vaccines to as many people as possible.”


The work of places such as the Serum Institute of India are examples of how this collaboration can work at its best. Can the Minister say what the Government will do to encourage and support more examples of such collaboration worldwide? Can he also say whether the UK Government plan to donate some of the spare doses that they have ordered to less developed countries and on what timescale this might be enacted?

The Statement refers to the end of shielding on 1 April. As a shielder, I have received another long letter from Matt Hancock and Robert Jenrick which says to shielders:

“Until the social distancing rules are eased more widely, it is important that you continue to keep the number of social interactions that you have low and try to reduce the amount of time you spend in settings where you are unable to maintain social distancing. Everyone is advised to continue to work from home where possible, but if you cannot work from home you should now attend your workplace. Your employer is required to take steps to reduce the risk of exposure to COVID-19 in the workplace and should be able to explain to you the measures they have put in place to keep you safe at work … From 1 April you will no longer be eligible for Statutory Sick Pay … or Employment and Support Allowance … on the basis of being advised to shield. Clinically extremely vulnerable pupils and students should return to their school or other educational settings.”


I said last year when I received an almost identical letter that this feels very strange. You are told that shielding ends but you should continue to do all the things you were doing before shielding—unless you were in receipt of SSP or ESA, because that is no longer available for those who have to go back to work in an unsafe workplace. In response to a question about shielding I asked at a briefing the Minister kindly held for parliamentarians with Chris Whitty, he said that shielders who are immunosuppressed should continue to shield unless the results of the OCTAVE clinical trial for immunosuppressed people was available. But it has not been announced yet. There is total silence from the Government, but there are many immunosuppressed people who will have received this letter and think that they are okay to start moving around more.

The end of the Statement talks about safe discharge, and the £594 million for safe discharge is welcome, but is that to go to the NHS or the better care fund, or will part of it go to local government? Is the £341 million mentioned later in the Statement to support adult social care with the costs of infection prevention part of that same £594 million or is it in addition and completely separate? How will that money get to social care providers?

Once again, why is only adult social care getting this funding? Once again, paid and unpaid carers for young disabled people, who are often extremely vulnerable to any infections, not just Covid, appear to be excluded from this grant. Can the Minister please explain?